Mortality Following Clostridioides difficile Infection in Europe : A Retrospective Multicenter Case-Control Study

We aimed to describe the clinical presentation, treatment, outcome and report on factors associated with mortality over a 90-day period in Clostridioides difficile infection (CDI). Descriptive, univariate, and multivariate regression analyses were performed on data collected in a retrospective case-control study conducted in nine hospitals from seven European countries. A total of 624 patients were included, of which 415 were deceased (cases) and 209 were still alive 90 days after a CDI diagnosis (controls). The most common antibiotics used previously in both groups were β-lactams; previous exposure to fluoroquinolones was significantly (p = 0.0004) greater in deceased patients. Multivariate logistic regression showed that the factors independently related with death during CDI were older age, inadequate CDI therapy, cachexia, malignancy, Charlson Index, long-term care, elevated white blood cell count (WBC), C-reactive protein (CRP), bacteraemia, complications, and cognitive impairment. In addition, older age, higher levels of WBC, neutrophil, CRP or creatinine, the presence of malignancy, cognitive impairment, and complications were strongly correlated with shortening the time from CDI diagnosis to death. CDI prevention should be primarily focused on hospitalised elderly people receiving antibiotics. WBC, neutrophil count, CRP, creatinine, albumin and lactate levels should be tested in every hospitalised patient treated for CDI to assess the risk of a fatal outcome

The relationship between body mass index, waist circumference and glomerular filtration rate in young men

INTRODUCTION The aim of this study was to answer the question what the dependence of glomerular filtration rate from the body mass index and waist circumference is. MATERIAL AND METHODS The study included 48 men aged 18–30, 19 of which (40%) had normal weight, 15 (31%) – were overweight, and 14 (29%) were obese (n = 14). 25 men (52%) had waist circumference less than 94 cm, 8 men (16%) in the range 94-102 cm, and 15 (32%) had greater than 102 cm. Their height, weight, waist circumference, serum creatinine, BMI, were measured using GRF MDRD equations and Cockcroft-Gault equation. RESULTS GFR estimated by the Cockcroft-Gault equation in men with normal body weight was 124.5 ml / min ± 19.5 ml / min, with overweight – 156.7 ml / min ± 29.3 ml / min, with obesity – 215.1 ml / min ± 61.6 ml / min. GFR estimated by MDRD equation was: 107.5 ml / min ± 13.5 ml / min, 112.4 mL / min ± 17.4 ml / min, 115.1 mL / min ± 21.0 ml / min. GFR estimated by the Cockcroft-Gault equation in men with waist circumference 102 cm - 214.2 ml / min ± 60.2 ml / min. GFR estimated by MDRD formula respectively was 106.4 ml / min ± 13.4 ml / min, 119.5 mL / min ± 13.5 ml / min, 114.8 mL / min ± 22.1 ml / min. Significant differences between groups occurred only after application of the Cockcroft-Gault equation. CONCLUSIONS The results of this study support the assertion that the MDRD formula is more credible than the Cockcroft-Gault equation to assess renal function in patients with overweight and obesity, including abdominal obesity.WSTĘP Celem przedstawionej pracy była próba odpowiedzi na pytanie, czy istnieje zależność między filtracją kłębuszkową (GFR) i wskaźnikiem masy ciała (BMI) oraz obwodem talii. MATERIAŁ I METODY Badaniem objęto łącznie 48 mężczyzn w wieku 18-30 rż, wśród których 19 (40%) miało prawidłową masę ciała, 15 (31%) – nadwagę, a 14 (29%) było otyłych (n=14). U 25 mężczyzn (52%) obwód talii był mniejszy niż 94 cm, u 8 (16%) mieścił się w przedziale 94–102 cm, a u 15 (32%) był większy niż 102 cm. Określono wzrost, masę ciała, obwód talii, stężenie kreatyniny w surowicy, BMI, eGRF za pomocą wzorów MDRD i Cockcrofta-Gaulta. WYNIKI GFR oszacowane wg wzoru Cockcrofta-Gaulta u mężczyzn z prawidłową masą ciała wynosiło 124,5 ml/min ± 19,5 ml/min, z nadwagą – 156,7 ml/ min ± 29,3 ml/min, z otyłością – 215,1 ml/min ± 61,6 ml/min. GFR oszacowane wg wzoru MDRD wynosiło odpowiednio: 107,5 ml/min ± 13,5 ml/min, 112,4 ml/min ± 17,4 ml/min, 115,1 ml/min ± 21,0 ml/min. GFR oszacowane wg wzoru Cockcrofta-Gaulta u mężczyzn z obwodem talii 102cm - 214,2 ml/min ± 60,2 ml/min. GFR oszacowane wg wzoru MDRD wynosiło odpowiednio 106,4 ml/min ± 13,4 ml/min, 119,5 ml/min ± 13,5 ml/min, 114,8 ml/min ± 22,1 ml/min. Istotne różnice pomiędzy grupami występowały jedynie po zastosowaniu wzoru Cockcrofta-Gaulta. WNIOSKI Wyniki niniejszej pracy pozwalają na stwierdzenie, że wzór MDRD jest bardziej wiarygodny niż wzór Cockcrofta-Gaulta w ocenie czynności nerek u osób z nadwagą i otyłością, w tym z otyłością brzuszną